SCTS has been asked by NHS England for an opinion regarding the impact of Covid 19 on cardiothoracic surgery.

We have submitted the two documents attached: CTS Covid 19 and CTS escalation. They set out how our specialty will react and be affected by the pandemic.

1. That elective surgery will cease, in-house surgery will be triaged and where possible emergency surgery will continue. Treatment for cancer should continue where possible.

2. Outpatient visits will be minimised and follow up done by telephone / skype

3. MDT presence minimised but important to maintain communication with referrers for cancer and unstable patients

4. In the recovery phase it will be important to focus care on urgent patients whose treatment has been delayed due to the pandemic.

As cardiothoracic surgeons and members of the cardiothoracic team we have skills and expertise that will be very useful to our colleagues coping with Covid 19 patients.

For instance, if anaesthetic rooms and theatres become additional ITU / HDU capacity, cardiac and thoracic surgeons may be able to offer their help to the intensive care teams. We have generic skills assessing sick patients with respiratory failure and we may be able to contribute to triage at front of house or medical wards.

We also attach four others papers:

a. The WHO document on the management of Covid 19

b. Kings Critical Care summary of the evidence

c. JAMA publication on the use of Critical Care in Lombardy with its supplementary graph on predicted ICU usage.

d. Joint statement from the joint Colleges of Surgery

We hope this email is informative and that you regard our response as sensible.

Please let us know of other ideas and solutions to help our specialty through this pandemic.

Yours sincerely,